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Sensory Assessment List

Sensory Assessment List Robert Cox, Life Recovery Consulting, 2016 Tactile Issues (Touch): Issue Seeks Avoids Neutral Being touched specific areas (specify) Hugs, snuggling, etc Clothing: tight, loose, materials (specify) Getting hands, face, etc messy or wet Using towels after bath Crowds or personal space issues Walking barefoot Personal grooming (brushing hair, teeth, nails, etc) Scores: _____ _____ _____ Proprioceptive issues: Issue Seeks Avoids Neutral Jumping, bouncing into things, climbing, hanging, etc Perching in high places, risky bike riding, jumping from heights, other risky behavior Fine motor tasks (picking up small beads, etc) Physically demanding tasks requiring muscle Having eyes closed or covered while walking Scores: _____ _____ _____ Vestibular Issues: Issue Seeks Avoids Neutral Spinning in circles Shaking head from side to side or back and forth, hanging upside down Rocking Balance activities (biking, skating, etc) Walking on soft deep carpet, snow, sand Riding in a car or on a sled, etc Scor

Hidden picture puzzles or mazes Going to crowded public places Light sensitivity or seeking Action packed, colorful TV or computer Using a kaleidoscope or looking through colored glasses Scores: _____ _____ _____ Auditory Issues:

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